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NREMT Paramedic Trauma Exam Prep

Category - Paramedic Trauma

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You are called to the scene of a 24-year-old male who fell through a glass table.

There is a 4-inch laceration along his forearm and into the antecubital fossa. There is fast flowing dark red blood pulsing from his arm. The patient is pale and cool, and confused. Respiratory rate is 24 per minute.

What is the best treatment strategy for this patient?
  1. Immediate application of a tourniquet, rapid transport, IV fluid administration to maintain systolic blood pressure at greater than 90, keep the patient warm
  2. Strong pressure held to site with elevation, bandaging, rapid transport, oxygen administration, large bore IV with fluids to maintain systolic blood pressure to greater than 90, keep the patient warm
  3. Pick out the small pieces of glass from the wound, pack with gauze, and hold pressure while transporting to the hospital
  4. Immediate tourniquet, ventilation via BVM, rapid transport, large bore IV with fluids en route.
Explanation
Answer: B-Controlling the bleeding and addressing hypovolemia are the most urgent issues in this scenario.

The first steps to controlling bleeding involve applying pressure and elevating the wound site. A tourniquet would be the next step if these actions are insufficient. IV fluids as necessary to maintain the patient’s blood pressure.
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